Heartburn Medications after Nissen Fundoplication

Sandy from Houston sent us this question: “I had partial Nissen 6 months ago. Just had an upper endoscope and my surgeon told me there was irritation in lining and I should take proton pump inhibitors again. I don’t feel that is correct route”.

Dear Sandy,

Properly performed Nissen or Toupet (partial) fundoplication is associated with a very high success rate. Nissen fundoplication eliminates any form of reflux from the stomach into the esophagus. 6 months after surgery esophageal lining irritation should have healed and your acid reflux symptoms completely resolved. One of the benefits of Nissen fundoplication is the cessation of all forms of antacid medications including proton pump inhibitors. Lifelong PPI use is associated with serious side effects. Resuming PPIs after Nissen or Toupet fundoplication is not the “correct route” as you mentioned.

You need to be evaluated by a competent acid reflux specialist to properly diagnose your particular condition and tailor the treatment accordingly. If the surgery was not properly performed it needs to be redone. Revision Nissen fundoplication surgery is slightly more complicated than primary surgery but still quite effective at alleviating your acid reflux symptoms. I am not sure why you had a partial fundoplication instead of 360 fundoplication. A number of surgeons don’t feel comfortable performing a Nissen or 360-degree fundoplication for fear of post-operative dysphagia. However, at Houston Heartburn and Reflux Center our post-Nissen fundoplication dysphagia rate is less than 1 in 1000. Your partial fundoplication can easily be converted to Nissen fundoplication and give you lifelong relief from heartburn and acid reflux.